Getting Connected: A Special Report on Electronic Health Records

April 01, 2011 06:30 pm Platte City, Mo.; Spring Hill, Kan. —
A national conversation on the value of health information technology, or health IT, and electronic health records, or EHRs, is taking place as the federal government continues to push physicians to adopt the technology via the American Recovery and Reinvestment Act and the Patient Protection and Affordable Care Act. Talking about the benefits of health IT, however, is one thing. Seeing how family physicians actually use the technology in a busy family medicine practice is quite another, particularly as FPs are on the front lines of implementing EHRs.

04/01/2011 —
As the medical community continues its trek into the age of health information technology -- spurred, in no small part, by federal incentives to adopt electronic health record, or EHR, systems, along with the threat of financial reprisals for resisting -- family physicians are further along the road than physicians in other specialties. And those federal incentives for adoption and comprehensive utilization could very well keep family docs on the cutting edge.

04/01/2011 —
When it comes down to it, the chief motivation behind the health care industry's move to adopt health information technology, or health IT, is really very simple: patients. Give them better, safer care that they can afford to access. So when family physician V. Paula Messmore-Arn, M.D., decided to take the health IT plunge, patients were her central focus. Specifically, she wanted to improve the quality of care in her practice and "make a difference in patients' lives."

04/01/2011 —
The promise of reaping the rewards of data aggregation and analysis on a national scale is just one of the many factors behind the health information technology movement that continues to gain ground across the U.S. health care system. And the Distributed Ambulatory Research in Therapeutics Network, or DARTNet -- of which the AAFP National Research Network, or AAFP NRN -- is a founding partner, is on the verge of realizing that promise.

04/01/2011 —
One of the basic components of the federal government's incentive program for adopting health information technology is a funny little term: "meaningful use." To receive the incentives, physicians have to adopt a system that ensures they can apply meaningful use criteria to their use of an electronic health record, or EHR, system. That's the reason behind the federal government's involvement in the business of certifying EHRs.

04/01/2011 —
Jen Brull, M.D., of Plainville, Kan., has always operated a financially successful family medicine practice; consequently, she was able to invest in an electronic health record, or EHR, system three years ago.

04/01/2011 —
A solo FP, Kay Lee, M.D., of Houston, bought her first electronic health record, or EHR, system in 2005. Within six months, she had transferred most of her patient records onto the new system, leading to better documentation, greater efficiencies and a higher level of care for her patients. But in 2010, Lee discovered that the manufacturer of her EHR was discontinuing the product line in 2011, putting an end to updates and technical support.

04/01/2011 —
Like most other segments of the health care community, family medicine residencies are reading the writing on the wall when it comes to implementing health information technology. Almost all of the nation's 451 family medicine residencies use an electronic health record, or EHR, system, and are preparing their residents to be savvy users of EHRs, registries and other health IT tools.

04/01/2011 —
Recognizing that health information technology is the wave of the future -- if not the present -- family medicine educators say that medical students should be exposed to all aspects of health IT, including electronic health records, or EHRs, as early as possible in their academic careers. That way, these educators contend, students will be well prepared when they encounter EHRs in their residencies and future clinical practices -- especially if they will be practicing primary care.

04/01/2011 —
The health information technology movement in the United States, which has struggled to move medicine in the same direction as the rest of business and industry, started long before President George W. Bush's Jan. 20, 2004, State of the Union address. That night, Bush told Americans that computerized health records would help avoid "dangerous medical mistakes, reduce costs and improve care."

04/01/2011 —
As the drive to fully implement electronic health records, or EHRs, and health information technology, or health IT, continues in the United States -- spurred, in large part, by the federal government's increasing focus on the issue -- a number of organizations, including the AAFP, have developed resources to help physicians with the process.

04/01/2011 —
I think it's wonderful that the government is trying to move physicians to EHR technology by rewarding them financially for meaningful use. However, I'm not sure the program's carrot-and-stick approach -- with incentives for those who become meaningful users and, eventually, penalties for those who don't -- is the best way to go about it. I also worry about unintended consequences.

04/01/2011 —
We're on a meaningful use-certified EHR here at our university's health services, and we participate in Medicare for our retired staff members and their families. We already meet some of the meaningful use requirements, too. But are we going for the incentive money? The answer is no.

04/01/2011 —
Our small group practice participates -- reluctantly -- in Medicare, and since we were early adopters of EHR technology, we currently meet about 85 percent to 90 percent of the meaningful use criteria all the way through to Stage 3. But I'm not sure we will ever see a dime of the incentive money. If we don't meet just one objective because we don't think it's good for the practice or our patients, we won't get anything.

04/01/2011 —
I've been on an EHR for six years and totally paperless for at least three. I think the primary target of the meaningful use money isn't doctors like me, who already have EHRs, but doctors who don't, to induce them to start.

04/01/2011 —
The government's idea of "meaningful use" and the strings attached to getting the incentive payments are the chief reasons I decided to opt out of Medicare. I have two main objections to meaningful use. One is bureaucratic interference with EHRs. The other is ideological -- I truly believe the state has no business knowing people's medical data.

04/01/2011 —
I started my solo, small-volume "micropractice" about nine months ago. I have no employees and practice in a one-room clinic inside a pharmacy building -- my reception area is part of the pharmacy space. I wanted to distinguish my practice and keep my overhead low so I could serve the uninsured, so I chose a pharmacy as an informal ally and landlord. It's working well.

04/01/2011 —
I practice with two other family physicians in an integrative medical practice that combines conventional and complementary therapies. I've had an EHR since 2006. But I won't get any government money for meaningful use because I don't participate in Medicare (or any other insurance, either).